Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

Paediatric stroke care and outcomes: insights from the Australian Stroke Clinical Registry (123208)

Mark Mackay 1 , Belinda Stojanovski 1 , Mulugeta Birhanu 2 , Lachlan Dalli 2 , Catherine Burns 2 , Monique F Kilkenny 2 3 , Rohan Grimley 4 , Violet Marion 3 , Julie L Morrison 3 , Nicola Fearn 1 , Louise Sparks 5 , Olivia-Paris Quinn 1 , Adriane Sinclair 5 , Michael Fahey 6 , Kelvin Hill 7 , Natasha A Lannin 2 , Dominique A Cadilhac 2 3
  1. The Royal Children's Hospital, The Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Parkville, Victoria, Australia
  2. Stroke and Ageing Research, School of Clinical Sciences , Monash University , Clayton, Victoria, Australia
  3. Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
  4. School of Medicine and Dentistry, Griffith University, Birtinya, Queensland, Australia
  5. Queensland Children's Hospital, University of Queensland, Brisbane, Queensland, Australia
  6. Monash Children’s Hospital, , Monash University, Clayton, Victoria, Australia
  7. Stroke Foundation, Sydney, NSW, Australia

Background/Aims

The Australian Stroke Clinical Registry (AuSCR) supports improvements to the quality of acute stroke care, irrespective of age or type of admitting hospital (paediatric or adult). We aimed to examine the care by admitting hospital (paediatric or adult) and outcomes received by paediatric patients with acute stroke.

 

Methods

Data were analysed from AuSCR hospitals (2018–2023) for patients aged <18 years. Eligible registrants/proxies (usually parents) were invited to complete an outcome survey between 90-180 days from admission. This included an age-specific quality-of-life survey (PedsQL; 0-100 [best health]). Descriptive analyses were presented by age-group and admitting hospital.

 

Results

There were 258 paediatric episodes (45% female, 49% 0-4 years, 83% ischaemic). Children aged <12 years (vs 12-17 years) were more often treated in paediatric hospitals (64%, 47% from one Victorian hospital); those admitted to adult (vs paediatric) hospitals were more likely to be provided thrombectomy (11/29 [37%] vs 5/61 [8%]; P≤0.001), but there was no significant difference in thrombolytic therapy provision (5/43 [12%] vs 5/93 [5%]; P=0.14). Most (13/16) thrombectomies occurred in patients aged 13-17 years. Median length of stay was longer among those treated in paediatric hospitals versus adult hospitals (17 [IQR 27] days vs 3 [IQR 9] days; P≤0.001). Among 123 respondents to the PedsQL, the mean total score was 71/100 [SD 19], with differences by age group. Psychosocial health scores were lowest in 8-12 year-olds (mean=67).

 

Conclusion

We provide novel insights on Australian treatment trends by admitting hospitals for children with stroke and their outcomes, including psychosocial health.